Blog: National Partnership for Action
Posted on 8/1/2013 by Dora Tao
According to estimates from the Centers for Disease Control and Prevention, 1 in 110 children in the United States is affected by Autism Spectrum Disorder (ASD), and the rates are rapidly increasing. ASD can affect human development in a variety of ways and may interfere with an individual’s social interactions. While no single cause of autism has been discovered, trends have shown possible relationships between ASD and certain other conditions such as Down Syndrome.
It can often be difficult for parents to realize that their child is autistic. Some children may, at first, appear to be shy or have difficulty focusing before receiving the diagnosis. Although relatively little is known about ASD, symptoms of ASD usually become most obvious during early childhood (2 to 6 years old). Diagnosing ASD can be complex, however, because many of its symptoms often coexist with other health problems such as seizures, gastrointestinal issues, sleep issues and attention deficit/hyperactive disorder (ADHD), and therefore may be associated with these other conditions.
An earlier diagnosis gives parents and medical professionals more time to build an education and therapy plan that will best cater to the child’s needs for the future. However, the social and environmental factors influencing autistic children can greatly impact their treatment plans and management as they grow into adulthood.
A recent study published in Pediatrics done by researchers from Massachusetts General Hospital (MGH), however, showed that there were racial and ethnic disparities in the number of autistic children who went to see a specialist. This study of over 3,500 autistic children found that while 37 percent of white children saw specialists, only 30 percent of African American autistic children received specialized care. The greatest disparity came in children who saw a gastroenterologist, with 14 of white children and only 10 percent of Hispanic children and 9 percent of African American children receiving care.
A 2002 study from the Journal of the American Academy of Child & Adolescent Psychiatry identified an additional inequality; Medicaid-eligible white children were usually diagnosed earlier than Medicaid-eligible minority children with autism.
Although exact reasons behind these findings were not cited in the studies, researchers from the MGH study have hypothesized as to why minority autistic children are less likely to receive specialized care. Possible explanations include health care accessibility and cultural competency issues that would prevent minority families from following up with specialists that they are referred to, and/or differing frequencies of doctor referrals to appropriate services. A paper that was published in early 2012 also found that there may be differences in autism symptoms between non-minority and minority children based on cultural and linguistic gaps between parents and health care professionals.
With the growing rates of ASD in the United States, it is important to notice the emerging disparities in our communities. We need to better understand some of the challenges that Hispanic and African American families may be facing when accessing services so that we can ensure that all autistic children are receiving the best quality care that they can.
To achieve wellness, it is important to consider social factors in addition to treatment and care in order to ensure health equity for all. Not only do we need to make health professionals more aware of the disparities that may be afflicting minority communities, we also need to ensure that minority communities are able to access all the services they may need.
Take action! End health and healthcare disparities among minority communities by joining the National Partnership for Action to End Health Disparities (NPA).
For more information about autism, please check out http://www.autismspeaks.org
Posted in: Health Minority Populations OMH NPA Partners NPA Partners Health Disparities African American Health Equity Hispanic/Latino Mental Health | Comments (4) | Add a Comment | Comment Policy | Permalink
Posted on 7/31/2013 by David K. Mineta & Rep. Ben Ray Luján
Since 2008, July has been recognized as National Minority Mental Health Awareness Month, providing an opportunity to explore issues concerning mental health and substance use disorders in our communities. As a 2012 National Survey on Drug Use and Health (NSDUH) illustrates, substance abuse and mental illness remain intricately linked. In 2001, approximately 42 percent of adults who reported substance use within the last year – or 8 million out 18.9 million – also reported suffering from a mental illness as well.[i] In light of these staggering numbers it is important that we join with our many partners to raise awareness about substance use disorders and mental health, and to provide resources to support individuals, families, and communities across the Nation.
A priority of the Obama Administration’s National Drug Control Strategy (Strategy) is to reduce the demand for drugs significantly through effective prevention, intervention, treatment, and recovery support. Looking closely at the NSDUH data, we can see trends in drug use among various ethnic and cultural groups and in different geographic regions. These trends compel us to seek approaches tailored to specific groups and parts of the country. For example, among persons aged 12 or older in 2011, American Indians or Alaska Natives had the highest rates of illicit drug use (13.4 percent), followed by Native Hawaiians or Other Pacific Islanders (11 percent).[ii]
While the Federal Government plays a vital role in developing policies, these broad approaches only work if they meet the needs of local communities.
There are a number of tools available to assist communities with assessment, planning, implementation, and outcome evaluation of substance abuse prevention programs. One such tool, the National Registry of Evidence-based Programs and Practices (NREPP), is a searchable database of programs shown to be effective at helping community leaders select target populations. For example, there are more than 70 substance abuse prevention programs for assisting Latino youth, more than 40 for helping Native American youth, and others designed specifically for girls.
Minority Mental Health Awareness Month provides a catalyst to highlight the link between mental health, substance abuse, and minority communities, but let us all make mental health and substance use disorder services a priority throughout the year; to help empower individuals, strengthen families, and save lives. With dedication and focus, and the support of our family, friends, and neighbors, we can work together to make a difference for those who know the challenges of substance use disorders, and continue to face them.
[i] Figure 4.2 Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-45, HHS Publication No. (SMA) 12-4725. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012
Posted in: Health Promising Practices Health Disparities Prevention Mental Health Minority Health Minority Mental Health Month | Comments | Add a Comment | Comment Policy | Permalink
Posted on 7/30/2013 by Larke Nahme Huang, Ph.D.
A visit to the doctor can be daunting enough, but imagine how much more challenging it could be if you couldn’t understand your doctor or if your doctor didn’t take into account your health beliefs or practices? Language and culture are critical factors to consider in providing high quality health care and services, and with the rapidly changing demographics of the nation, cultural and linguistic competency has never been more important.
In April, the U.S. Department of Health and Human Services’ Office of Minority Health unveiled the enhanced National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards), expanding the definition and scope of the first CLAS standards issued in 2000. The CLAS standards are intended to advance health equity, improve quality and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. So what do the CLAS standards mean for behavioral health care systems and practitioners?
Research shows that there are disparities in behavioral health among racial, ethnic, sexual and gender minority populations. A recent report on 2003-2011 data from the National Survey on Drug Use and Health (NSDUH) found that Hispanics are more likely than non-Hispanics to have a need for substance use treatment but are less likely to receive treatment at drug or alcohol rehabilitation facilities, hospitals or mental health centers. Combined 2003 to 2011 NSDUH data also indicates that African Americans were less likely than persons of other racial and ethnic groups to need alcohol use treatment in the past year, but more likely to need illicit drug use treatment. Another NSDUH report found that substance use rates were generally higher among American Indian or Alaska Native adolescents compared with national averages. Among individuals admitted for substance abuse treatment, methamphetamines were reported as the primary substance of abuse for three times as many Asian Americans and Pacific Islanders (AAPIs) than for all other races combined, according to data from the Treatment Episode Data Set (TEDS). Studies have also shown that minority populations have less access to behavioral health care, receive lower quality care and experience worse outcomes even when they do receive care. Barriers such as stigma, cultural beliefs and limited English proficiency can contribute to these disparities.
Implementing strategies to improve and ensure cultural and linguistic competency in our behavioral health care systems is a powerful way to address these disparities and ensure all populations have equal access to services and supports. Capacity building efforts focused on improving cultural and linguistic competency and incorporating the CLAS standards in systems can elevate awareness; enhance the ability to monitor program access, service use and outcomes; and improve quality as a result. The enhanced standards emphasize the importance of strong leadership and governance and how all members of an organization play a critical role in more fully serving the health care needs of their communities. Practitioners and administrators can participate in training to better understand clients and be responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs. At a systems level, some states have taken steps to weave the cultural and linguistic competency into the fabric of their health systems, by passing legislation to implement cultural competency standards.
This National Minority Mental Health Awareness Month, I invite you to learn more about the enhanced CLAS standards and think about how you can advance behavioral health equity by incorporating these practices, starting with checking out the Blueprint for extensive explanations of the standards and implementation strategies. You can also find more information about behavioral health disparities and behavioral health resources on SAMHSA’s Office of Behavioral Health Equity website and the National Network to Eliminate Disparities in Behavioral Health website.
Posted in: Health Health Disparities CLAS Cultural & Linguistic Competency Mental Health Minority Health Minority Mental Health Month | Comments | Add a Comment | Comment Policy | Permalink
Posted on 7/29/2013 by J. Nadine Gracia, MD, MSCE
One in four.
That's how many adults are facing mental health problems in our country - and there is evidence to suggest that the burden of mental health issues may be even greater among minority communities. But too often, the causes and consequences of untreated mental health problems are left out of the conversation when we talk about improving the health of our most vulnerable and underserved. For communities that are already confronting widespread barriers to health and opportunity, the consequences of mental health problems - among them, decreased worker productivity, increased economic costs to the health care system and heightened risk of premature death, according to the Substance Abuse and Mental Health Services Administration - can have a devastating toll.
During National Minority Mental Health Awareness Month, we recognize the costly burden of mental health problems for diverse communities, and we shine a light on avenues for prevention, treatment, wellness and recovery. We acknowledge that mental health problems touch all communities, in all parts of our country - but that the struggle for equity persists in mental health as well.
As a pediatrician, I have seen the impact of mental health problems in minority communities first hand. Half of all mental health disorders show first signs before a person reaches the age of 14, and three quarters of mental health disorders begin before age 24.
Early in my career, I remember one of my teenage patients was diagnosed with paranoid schizophrenia. I remember her family's uncertainty. Some of her family members questioned the diagnosis, suggesting that perhaps she was simply in the habit of acting out, because it was difficult to accept the diagnosis. I have seen how the issue of mental illness is still a taboo topic in many minority communities. But it is important for our communities to understand that mental health is part of our overall health and wellness.
According to the Centers for Disease Control and Prevention (CDC), suicide is the second leading cause of death for American Indians and Alaska Natives between the ages of 10 and 34. Asian American teens are more likely than their white peers to report considering or attempting suicide. (View data on mental health problems and treatment in minority populations).
Fueling these disparities is the fact that minorities have less access to mental health services; are less likely to receive needed mental health services; and those in treatment often receive a poorer quality of mental health care. According to the CDC, African Americans tend to delay seeking help for mental health issues, although they are 20 percent more likely to report having serious psychological distress than whites, and Latinos receive mental health treatment half as often as whites. Those who do get help may receive care that is not always respectful, or culturally and linguistically appropriate.
To help reduce these disparities and improve quality of care, the Office of Minority Health released the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, as a tool to help providers and organizations provide services that fit each person's unique needs at every point of contact. The CLAS Standards take into account the distinct culture of individuals and groups, and include aspects like language preference, spirituality, sexual orientation, gender preference and disability status - in addition to race and ethnicity.
The National CLAS Standards are one of the many ways that we are working to advance health equity. Another is the Affordable Care Act. The Affordable Care Act, signed into law by President Obama in 2010, improves access to quality, affordable health care, with a focus on prevention and wellness. Because of the health care law, millions of Americans will gain health insurance and with that, gain opportunities for better health. The Affordable Care Act also invests in community health centers, expanding the number of health centers across the country and the services they provide such as behavioral health care. Also, funds will be distributed to Federally Qualified Health Centers to increase their capacity to meet the needs of minority communities. Work is being done in these health centers to integrate primary care and behavioral health, introducing mental health care services in familiar community care settings.
The health care law will also provide one of the largest expansions of mental health and substance use disorder coverage in a generation. Beginning in 2014, most small group and individual health plans will be required to cover 10 Essential Health Benefit categories, including mental health and substance use disorder services, and will be required to cover them on par with medical and surgical benefits. More than 62 million Americans are expected to benefit.
The Affordable Care Act is one of the most powerful pieces of legislation for reducing health disparities and is already transforming the landscape of access to health care and services, including behavioral health care-especially for those communities in greatest need.
Throughout National Minority Mental Health Awareness Month, let us take this opportunity to raise awareness about mental health, and encourage all of our communities to speak out about these issues, so that no one has to bear the burden of mental illness alone and that everyone can live a healthy life.
To learn more about federal resources about mental health, visit Mentalhealth.gov. For more information about minority health and health disparities, visit the Office of Minority Health website at Minorityhealth.hhs.gov.
This blog also appears on PsychCentral: http://blogs.psychcentral.com/all-things/
Posted in: Health Health Disparities Affordable Care Act/Health Care Law Mental Health Minority Health Minority Mental Health Month | Comments (3) | Add a Comment | Comment Policy | Permalink
Posted on 7/24/2013 by Jeremy Hsiao
You probably know someone who is affected by mental illness.
According to the National Institute of Mental Health, one in four Americans currently suffer from a mental illness, and one in two will suffer from a mental illness in their lifetime. These statistics do not include the family, friends and community who are deeply affected by their loved ones' mental illness. Here at the Office of Minority Health, we are elevating the importance of this issue as a part of Minority Mental Health Awareness month.
During my freshmen year at the University of Maryland, I became involved with an on-campus organization called Active Minds. Active Minds' goal is to promote positive mental health while fighting the stigma associated with mental illness.
One of the first events that we put together was "Send Silence Packing." The centerpiece of this national event is 1,100 backpacks representing the number of college students that commit suicide annually. Some of the backpacks being displayed are the actual backpacks that these college students left behind. Family and friends will add stories and memorabilia so that whoever looks at the backpack can imagine the person that it was once attached to.
During that event, there was one backpack in particular that stood out. It belonged to a former student, John. John was rock climber, and a great student – sociable and beloved by everyone. His backpack must have had 50 or so personal letters from friends and family, each describing a precious memory they had of him. Those stacks of letters were all laminated and bound to the backpack by a single ring that seemed to be overwhelmed by the memories. Also attached to the backpack were pieces of rock-climbing equipment that he so often used with his buddies. It was obvious that John's backpack never looked like this when he was using it, but I have never been able to imagine anyone more vividly than John that day.
As I moved on, I recognized a woman looking at display in the far corner of the room. It was my 10th grade Earth, Space and Science teacher, Mrs. Suzanne Martin. When she saw me, she immediately gave me a hug and asked how I was adapting to college life. Mrs. Martin looked younger with her new hair style and she was as energetic as I ever remembered. When I asked her what she was doing here, she looked away and said, "I will show you". She took me to the entrance of the room and pointed to a backpack.
She took me to John's backpack. Suzanne Martin was John's mother.
At this point, I realized that I knew someone who was affected by mental illness.
Luckily, there are resources available for people living with mental health issues as well as their family, friends and caregivers. President Obama and Secretary Sebelius recently launched the website mentalhealth.gov, which examines mental health from many angles. The website includes the following mental health resources:
Join me and the Office of Minority Health to become part of the movement to promote positive mental health.
*Names have been changed.
Posted in: HHS Federal Mental Health Minority Mental Health Month Youth Peer Educators | Comments | Add a Comment | Comment Policy | Permalink
About the Blog
The NPA works to achieve health equity -- the highest level of health for all people. This blog is a venue for professionals from all fields and sectors to share their thoughts on pressing issues, news and events pertaining to health equity. Follow and participate in this candid discussion.
Recent Blog Posts
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→ Promoting Health Equity in Latino Communities
→ Newly Released: A White Paper for Health Care Providers on Cultural Competency
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→ The Mid-Atlantic Regional Health Equity Council Explores How Unconscious Bias Impacts Health
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